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We've reported extensively on the ties between pharmaceutical companies and the physicians they fund to speak, consult and do research [2]. But doctors aren't the only ones taking money from drug companies'and they're not the only stakeholders in the field of health whose public disclosures aren't complete.

According to a new study [3] in the American Journal of Public Health, not-for-profit health advocacy groups like the American Diabetes Association and the National Alliance on Mental Illness also get money from drug companies in the form of grants that'more often than not aren't disclosed by those groups.

The study examined more than 160 health advocacy organizations that received funding from Eli Lilly in the first half of 2007. (Lilly was the first company to make its grant registry public.) Here's what the analysis found:

As an aggregate, 25% of HAOs acknowledged Lilly funding anywhere on their Web site. Eighteen percent acknowledged Lilly in their 2007 annual report, 1% acknowledged Lilly on a corporate sponsors page, and 10% acknowledged Lilly as the sponsor of the grant event reported in the [Lilly Grant Registry.]

Health advocacy groups often advocate for research and the approval of new drugs on top of promoting public awareness. According to the study, their reputation as a trusted resource for information on specific diseases and their treatments should prompt "far more detailed" disclosure of their corporate grants and industry relationships.

This report isn't the first time such ties have been spotlighted.

The National Alliance on Mental Illness, or NAMI, came under similar scrutiny back in 2009 when Sen. Charles Grassley, a top Republican, began making inquiries.

From 2006 to 2008, the group took in nearly $23 million [4] in drug company donations'about three-quarters of its fund-raising. At the time, NAMI's executive director told The New York Times that the percentage of money from pharma has been higher than we have wanted it to be201D and promised greater disclosures.

Following the revelations about NAMI, Sen. Charles Grassley sent letters [5] to 33 health advocacy groups asking them to disclose details about their financial ties to drug and device makers. He has not released the responses he received from the groups.

Today's report, however, highlighted continued concerns about the degree to which a group's funding influences its advocacy and helps boost sales for drug companies making donations. Here's an example from the report, involving NAMI:

This lack of transparency is disappointing because, either by design or through a convergence of interests, the HAOs in the current study pursued activities that promoted the sale of Lilly products.

In the area of neurosciences, Lilly gave NAMI $450,000 for its Campaign for the Mind of America. NAMI has advocated that cost should not be a consideration when prescribing for patients. "For the most severely disabled,'' insisted NAMI, "effective treatment often means access to the newest medications such as atypical anti- psychotic and anti-depressive agents. . . . Doctors must be allowed to utilize the latest breakthrough in medical science . . . without bureaucratic restrictions to the access for life-saving medications.''To the degree that NAMI's campaign succeeded, the market for Lilly's neuroscience drugs expanded.

As we've noted [6], the health care law contains a provision requiring greater disclosure of drug company payments to physicians by 2013, but it does not include company payments to health advocacy organizations.